COME TO THE NHS FOR NEEDLESS SURGERY

Hard to get needed surgery but easy to get unnecessary surgery -- Just another government bureaucracy doing the sort of thing that government bureaucracies do

Patients with ailments that could be cured by drugs are instead undergoing unnecessary and painful surgery simply because of where they live, according to England’s Chief Medical Officer. Professor Sir Liam Donaldson said that by scrapping operations such as hysterectomies and tonsil removal the NHS could save billions of pounds a year. His annual report, which was released yesterday, calls for urgent action to reduce the wide variations in care experienced across the country and urged the National Institute for Health and Clinical Excellence to issue guidelines on which treatments doctors should stop prescribing.

Sir Liam said that tonsillectomies and hysterectomies were still regularly performed despite guidelines recommending treatment through drugs. He said that children from low-income areas were more likely to have their tonsils removed, but if the tonsillectomy rate in low-income areas matched that of higher-income ones, about 8,000 operations could be avoided every year, saving about 6 million pounds.

Doctors performed about 38,000 hysterectomies in 2004-05. However, there were fewer operations in north central London than in Northumberland and Tyne and Wear. “In my view, this level of variation in clinical practice is not acceptable,” Sir Liam said. “If the average rate of hysterectomy in England could be reduced to that achieved in the 20 per cent of the country with the lowest current rates, then 5,900 operations, costing 15 million pounds, could be avoided per annum.”

Sir Liam’s report also highlighted the wide variations in the treatment of coronary heart disease. In some parts of the country, heart attack patients who needed revascuralisation — a procedure that improves blood flow to the heart — were twice as likely to be offered less intrusive but just as effective operations as those in other areas. Another example of waste was the 574 different hip joints the NHS used. He said that these could be reduced significantly.

Sir Liam proposed a system of incentives and penalties to encourage doctors to prescribe appropriate treatments. He said that computers in hospitals and GP surgeries could be programmed to block a doctor from prescribing a treatment that had little or no evidence of its worth. The NHS could also learn a great deal from the aviation industry and adopt standard operating procedures. This would not only encourage equitable care but also help to ensure better patient safety, Sir Liam said. “Inappropriate variation may be a function of poor knowledge, the flawed application of the correct knowledge, a lack of resources or the inappropriate allocation of extant resources,” he said.

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'Third World' health care in Queensland government hospitals

The report below gives you an idea of why nearly half of all Australians go to Australia's superb private hospitals instead

Hospital patients are waiting on trolleys, in chairs and even on the floor for up to 24 hours before a bed is available at a Brisbane emergency department. Staff at the Royal Brisbane and Women's Hospital are struggling with 30 per cent more patients to treat than they have beds for. They have told the Australian Medical Association that all 950 beds are full and capacity is overflowing. AMA president Dr Zelle Hodge said hospitals needed to operate at no more than 85 per cent capacity in order to be safe and to cope. "By operating at 130 per cent capacity, the Royal Brisbane Hospital is making conditions unsafe for patients and pushing staff beyond their limits," she said. "This is distressing for patients and their families, and is not the treatment they should be subjected to. "There are a lot of better ways the Government could spend taxpayers' money rather than advertising."

A nurse at one Brisbane hospital, who did not want to be named for fear of losing her job, said emergency patients were being put in extreme danger. "I have watched patients have cardiac arrests on ambulance trolleys in the corridor while waiting for a bed in the emergency department," she said. "Everyday patients wait far beyond their allocated time to receive treatment."

Government targets say treatment should be given within 30 minutes but a Federal Government annual report published this month shows that in 2004-05, Queensland emergency departments treated just 58 per cent of emergency patients within the recommended time. This month the Beattie Government boasted of more hospital beds and shorter waiting times in a glossy brochure "Keeping Our Promise" mailed at a cost of more than $300,000. Between December 2005 and May this year, the Government spent almost $2 million of taxpayers' money to reassure people about the health system is meeting their needs.

In contrast, Queensland Health reports released in April show patients are also waiting longer than the clinically desirable time for scheduled operations. Many who require urgent surgery are waiting up to a year, despite guidelines saying the operation should be carried out in 30 days.

Opposition health spokesman Dr Bruce Flegg said the Government must stop wasting money on publicity. "Clearly the situation with emergency departments has not improved, and no amount of spin and glossy brochures is going to make any difference," he said. Health Minister Stephen Robertson denied the occupancy rate at the Royal Brisbane had ever reached 130 per cent. He said the Government was investing $280.3 million into emergency departments over five years, and would increase the number of beds across the state by 860 over three years.

Source

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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